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de Goes ACG, Souza KAS, Tunes G, Alencar AP, Varella AC, Gooden TE, Thomas NG, Lip GY, Santos IS, Lotufo PA, Benseñor IM, Goulart AC. Predictive value of functional disability scales among stroke survivors: A long-term mortality evaluation in a Brazilian stroke cohort. J Stroke Cerebrovasc Dis 2024; 33:107487. [PMID: 37980846 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE To assess the influence of two functional scales- Modified Rankin Scale (m-RS) and Modified Katz Index (m-Katz Index) on long-term mortality in a stroke cohort. MATERIAL AND METHODS Among 760 stroke survivors (median age: 66 (IQR:56-75), 56.4 % women) m-Katz Index and m-RS scales applied at 1 and 6 months after stroke, were investigated in relation to 12-years of all-cause mortality. Kaplan-Meier survival curves were computed, and time-varying covariate Cox regression models were fitted to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) in all sample and by sex. The prognostic ability of the fitted models was computed for each model by six different measures. RESULTS After 12 years of follow-up (median survival time: 7.3 years), 311 participants died. Overall survival curves show lower survival rates among those with the highest levels of disability/dependence (all log-rank p-values <0.0001). These findings were confirmed in all regression models for both sexes, particularly in men who had higher levels of dependence on Activities of Daily Living (ADLs) by m-Katz Index and severe disability by m-RS and presented the highest HR of dying (HR: 3.34 (95 %CI: 2.27-4.92) and HR: 4.94 (95 % CI: 3.15-7.75), respectively). CONCLUSIONS Both the m-Katz Index and the m-RS scale were good predictors of long-term mortality, which is of importance for guiding the functional rehabilitation of stroke patients. Besides, high levels of disability and dependence were implicated with high mortality risks, regardless of sex.
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Affiliation(s)
- Ana Cristina G de Goes
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil.
| | - Karla A S Souza
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil
| | - Gisela Tunes
- Institute of Mathematics and Statistics, Universidade de São Paulo, Brazil
| | - Airlane P Alencar
- Institute of Mathematics and Statistics, Universidade de São Paulo, Brazil
| | - Ana C Varella
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil
| | - Tiffany E Gooden
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Neil G Thomas
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Gregoy Yh Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil; School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil; School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil; School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, Av. Lineu Prestes 2565, Butantan - Cidade Universitária, São Paulo, SP CEP 05508-900, Brazil; Department of Epidemiology, School of Public Health, Universidade de São Paulo, São Paulo, Brazil
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Gooden TE, Wang J, Carvalho Goulart A, Varella AC, Tai M, Sheron VA, Wang H, Zhang H, Zhong J, Kumarendran B, Nirantharakumar K, Surenthirakumaran R, Bensenor IM, Guo Y, Lip GYH, Thomas GN, Manaseki-Holland S. Generalisability of and lessons learned from a mixed-methods study conducted in three low- and middle-income countries to identify care pathways for atrial fibrillation. Glob Health Action 2023; 16:2231763. [PMID: 37466418 PMCID: PMC10360996 DOI: 10.1080/16549716.2023.2231763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Identifying existing care pathways is the first step for understanding how services can be improved to enable early diagnosis and effective follow-up care for non-communicable diseases (NCDs); however, evidence on how care pathways can and should be identified in low- and middle-income countries (LMICs) is lacking. OBJECTIVE To describe generalisability and lessons learned from recruitment and data collection for the quantitative component of a mixed methods study designed to determine the care pathway for atrial fibrillation (AF) in Brazil, China and Sri Lanka. METHODS Adults (≥18 years) that spoke the local language and with an AF diagnosis were eligible. We excluded anyone with a hearing or cognitive impairment or ineligible address. Eligible participants were identified using electronic records in Brazil and China; in Sri Lanka, researchers attended the outpatient clinics to identify eligible participants. Data were collected using two quantitative questionnaires administered at least 2-months apart. A minimum sample size of 238 was required for each country. RESULTS The required sample size was met in Brazil (n = 267) and China (n = 298), but a large proportion of AF patients could not be contacted (47% and 27%, respectively) or refused to participate (36% and 38%, respectively). In Sri Lanka, recruitment was challenging, resulting in a reduced sample (n = 151). Mean age of participants from Brazil, China and Sri Lanka was 69 (SD = 11.3), 65 (SD = 12.8) and 58 (SD = 11.7), respectively. Females accounted for 49% of the Brazil sample, 62% in China and 70% in Sri Lanka. CONCLUSIONS Generalisability was an issue in Brazil and China, as was selection bias. Recruitment bias was highlighted in Sri Lanka. Additional or alternative recruitment methods may be required to ensure generalisability and reduce bias in future studies aimed at identifying NCD care pathways in LMICs.
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Affiliation(s)
- Tiffany E Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jingya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alessandra Carvalho Goulart
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ana C Varella
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
| | - Meihui Tai
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Vethanayagan Antony Sheron
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Hao Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hui Zhang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jiaoyue Zhong
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Balachandran Kumarendran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | | | - Rajendra Surenthirakumaran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Isabela M Bensenor
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Yutao Guo
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Goulart AC, Varella AC, Gooden TE, Lip GYH, Jolly K, Thomas GN, Lotufo PA, Greenfield S, Olmos RD, Bensenor IM, Manaseki-Holland S. Identifying and understanding the care pathway of patients with atrial fibrillation in Brazil and the impact of the COVID-19 pandemic: A mixed-methods study. PLoS One 2023; 18:e0292463. [PMID: 37824516 PMCID: PMC10569511 DOI: 10.1371/journal.pone.0292463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is a major risk factor for stroke. To enable improvements to AF diagnosis and follow-up care, understanding current patient pathways and barriers to optimal care are essential. We investigated the patient care pathways and their drivers, and the impact of the COVID-19 pandemic on patient pathways in a middle-income country setting, Brazil. METHODS This mixed-methods study in São Paulo, included adults (≥18y) with AF from 13 primary/secondary healthcare facilities. Surveys using baseline, follow-up (administered ≥two months after baseline) and COVID-19 questionnaires (quantitative), and three focus group discussions (FGDs) were conducted. Minimum sample size for the quantitative component was 236 and we aimed to reach saturation with at least three FGDs for the qualitative component. Descriptive statistics were used for quantitative data and a content analysis was used for qualitative data to identify themes related to AF diagnosis and follow-up care. RESULTS 267 participants completed the baseline questionnaire: 25% were diagnosed in primary care, 65% in an emergency or inpatient department. At follow-up (n = 259), 31% visited more than one facility for AF care, and 7% had no follow-up. Intervals between international normalised ratio (INR) tests were increased during the pandemic, and the number of healthcare visits and availability of medication were reduced. Seventeen patients participated in three FGDs and revealed that AF diagnosis often occurred following a medical emergency and patients often delay care-seeking due to misconceptions about AF symptoms. Long waiting times, doctor/patient interactions and health system factors, such as doctor availability and the referral system, influence where participants visited for follow-up care. CONCLUSIONS Lack of public awareness and underdeveloped primary healthcare lead to delayed diagnosis, which impacts clinical outcomes and excess patient and healthcare system costs. Health system, care-provider, and pandemic factors disrupt timely and effective continuity of care.
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Affiliation(s)
- Alessandra C. Goulart
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ana C. Varella
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Tiffany E. Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Gregory Y. H. Lip
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
- Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Rodrigo D. Olmos
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
- Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
- Medical School, Universidade de São Paulo, São Paulo, Brazil
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Souza KA, Varella AC, Olmos RD, Romagnolli C, Gooden TE, Thomas GN, Lip GY, Santos IS, Lotufo PA, Benseñor IM, Goulart AC. Cardiovascular medications and long-term mortality among stroke survivors in the Brazilian Study of Stroke Mortality and Morbidity (EMMA). Geriatr Gerontol Int 2022; 22:715-722. [PMID: 35920018 DOI: 10.1111/ggi.14429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/04/2022] [Accepted: 06/05/2022] [Indexed: 12/01/2022]
Abstract
AIM To investigate the association between medication use and long-term all-cause mortality in a Brazilian stroke cohort. METHODS Both ischemic and hemorrhagic stroke were evaluated. Medication use was assessed as: never, only pre-stroke, only post-stroke, and continuous use. We evaluated anti-hypertensives, anti-diabetics, lipid-lowering drugs, anti-platelets, and anti-coagulants. Cox regression models were adjusted for sociodemographic and cardiovascular risk factors. RESULTS Among 1173 incident stroke cases (median age: 68; 86.8% were ischemic, 70% first-ever stroke), medication use was low (overall: 17.5% pre-stroke, 26.4% post-stroke, and 40% were under continuous use). Anti-hypertensives and anti-platelets (aspirin) were the continuous cardiovascular medications used most often, at 83.5% and 72%, respectively, while statins (39.7%) and anti-diabetics (31.3%) were the least used. Medication use (pre-stroke, post-stroke and continuous use) was associated with a reduction in all-cause mortality risk, particularly among those under continuous use (multivariable hazard ratio, 0.52; 95% confidence interval (CI), 0.46-0.66) compared with never-users. Among ischemic stroke patients, this effect was similar (multivariable hazard ratio, 0.52; 95% CI, 0.40-0.68). No significant associations were evident among hemorrhagic stroke patients. CONCLUSIONS The risk of all-cause mortality was reduced by 48% among those with ischemic stroke under continuous use of medications. Secondary prevention should be emphasized more strongly in clinical practice. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Karla As Souza
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Ana C Varella
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo D Olmos
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Carla Romagnolli
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Tiffany E Gooden
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - G Neil Thomas
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Gregory Yh Lip
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK, Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, Brazil.,Institute of Mathematics and Statistics, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.,School of Medicine, Universidade de São Paulo, São Paulo, Brazil
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Varella AC, Benseñor IM, Janovsky CCPS, Goulart AC, Birck MG, Santos IS, Brunoni AR, Lotufo PA. Thyroid-stimulating hormone levels and incident depression: Results from the ELSA-Brasil study. Clin Endocrinol (Oxf) 2021; 94:858-865. [PMID: 33386609 DOI: 10.1111/cen.14407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to prospectively evaluate whether TSH levels at baseline were associated with incident depression after four years of follow-up in a cohort of middle-aged adults, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS TSH and free-thyroxine (FT4) levels were evaluated at baseline. Depression diagnoses were performed using the Clinical Interview Schedule-Revised (CIS-R) at baseline and after a 4-year follow-up. Poisson regression models (95% Confidence Intervals) were built to evaluate the association between TSH quintiles at baseline and incident depression. All analyses were stratified by sex. Models were presented crude, adjusted for age and sex; and further adjusted for race, education, BMI, smoking, alcohol consumption, use of antidepressants/benzodiazepines, kidney function and comorbidities. RESULTS Mean age was 51.5 years, and 51.2% were women. Overall, low TSH levels (1st quintile) were associated with incident depression (adjusted RR = 1.36, 95% CI 1.02-1.81), remaining significant for women (adjusted RR = 1.64, 95% CI 1.15-2.33), but not for men. The same results were found when restricting analysis to euthyroid participants (adjusted RR = 1.46, 95% CI 1.08-1.99), also significant for women only (adjusted RR = 1.63, 95% CI 1.12-2.38). CONCLUSIONS Our results showed that low TSH levels were positively associated with incident depression, particularly among women. Similar results were found when restricting the analysis to euthyroid participants. In contrast, high TSH levels were inversely associated with incident depression, also among women.
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Affiliation(s)
- Ana C Varella
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Isabela M Benseñor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Carolina C P S Janovsky
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Alessandra C Goulart
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Marina G Birck
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Itamar S Santos
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Andre R Brunoni
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
| | - Paulo A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil
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Varella AC, Benseñor IM, Fonseca MJM, Griep RH, Pereira AC, Lotufo PA. Religious Service Attendance, Educational Attainment, and Hypertension at Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Hypertens 2020; 33:452-457. [PMID: 32170931 DOI: 10.1093/ajh/hpz199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/13/2019] [Accepted: 03/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Some religious dimensions have been associated with different health-related outcomes over many years. Attending religious services is one of these dimensions that were associated with hypertension, with inconsistent results. And religious involvement seems to be closely influenced by sociodemographic factors, such as education. Therefore, this study aimed to investigate the association between religious service attendance and hypertension according to levels of education. METHODS We analyzed baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Frequency of religious service attendance and presence of hypertension were assessed in all 15,105 participants at baseline. The analyses were stratified by two levels of education (less than high school and high school or more). Logistic regression models were used to obtain the association between religious service attendance and hypertension in both groups. RESULTS For those with high school or more, attending religious services was positively associated with hypertension (adjusted odds ratio [OR] = 1.14, 95% confidence interval [CI] 1.02-1.28). In contrast, for those with less than high school, attending services was inversely associated with presence of hypertension (adjusted OR = 0.73, 95% CI 0.55-0.96). CONCLUSIONS There seems to be a paradox in the association of religious service attendance and hypertension depending on the level of education.
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Affiliation(s)
- Ana C Varella
- Departamento de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Isabela M Benseñor
- Departamento de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Maria J M Fonseca
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Owaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Rosane H Griep
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Alexandre C Pereira
- Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina (FMUSP), Laboratório de Genética e Cardiologia Molecular, São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Departamento de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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Oiestad AJ, Martin JM, Cook J, Varella AC, Giroux MJ. Identification of Candidate Genes Responsible for Stem Pith Production Using Expression Analysis in Solid-Stemmed Wheat. Plant Genome 2017; 10. [PMID: 28724083 DOI: 10.3835/plantgenome2017.02.0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The wheat stem sawfly (WSS) is an economically important pest of wheat in the Northern Great Plains. The primary means of WSS control is resistance associated with the single quantitative trait locus (QTL) , which controls most stem solidness variation. The goal of this study was to identify stem solidness candidate genes via RNA-seq. This study made use of 28 single nucleotide polymorphism (SNP) makers derived from expressed sequence tags (ESTs) linked to contained within a 5.13 cM region. Allele specific expression of EST markers was examined in stem tissue for solid and hollow-stemmed pairs of two spring wheat near isogenic lines (NILs) differing for the QTL. Of the 28 ESTs, 13 were located within annotated genes and 10 had detectable stem expression. Annotated genes corresponding to four of the ESTs were differentially expressed between solid and hollow-stemmed NILs and represent possible stem solidness gene candidates. Further examination of the 5.13 cM region containing the 28 EST markers identified 260 annotated genes. Twenty of the 260 linked genes were up-regulated in hollow NIL stems, while only seven genes were up-regulated in solid NIL stems. An -methyltransferase within the region of interest was identified as a candidate based on differential expression between solid and hollow-stemmed NILs and putative function. Further study of these candidate genes may lead to the identification of the gene(s) controlling stem solidness and an increased ability to select for wheat stem solidness and manage WSS.
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